尽管记录在案的宫颈癌筛查和发病率与精神疾病相关的差异，但关于宫颈癌预防策略（例如人乳头瘤病毒（HPV）疫苗接种）差异的数据不足。我们的目的是调查瑞典女孩及其父母的精神疾病和神经发育状况与 HPV 疫苗接种的关系。这项基于人群的队列研究以瑞典学校为基础的 HPV 疫苗接种计划为基础，该计划为10-13岁女孩，12个月内注射第二剂。我们使用瑞典总人口登记册确定了 2002 年 1 月 1 日至 2004 年 3 月 1 日期间出生的所有女孩，即从 2012 年秋季启动到 2019 年 3 月期间有资格在疫苗接种计划中接种两剂疫苗的女孩。登记数据（国家患者登记册、处方药登记册、HPV 疫苗接种登记册、国家疫苗接种登记册、总人口登记册、多代登记册、健康保险和劳动力市场研究纵向综合数据库、教育登记册、国家宫颈筛查登记册和癌症登记册）用于定义个人和父母的心理健康状况，包括精神疾病和神经发育状况（通过临床诊断和处方精神药物的使用来定义）、HPV 疫苗的接种（第一剂和第二剂）以及社会人口学和临床特征。这两个结果是在女孩 14 岁生日之前接种第一剂 HPV 疫苗，以及在 15 岁生日之前接种第二剂 HPV 疫苗，这与个人和父母的心理健康状况有关，使用多变量泊松回归模型计算。115 104 名女孩被纳入研究中。研究人群。 2211 名女孩 (1·9%) 接受了任何心理健康状况的专家诊断。第一剂 HPV 疫苗的接种率为 80·7%（115 104 中的 92 912），并且在有任何精神健康问题的女孩中低于没有任何心理健康问题的女孩（调整后的相对风险 0·89 [95% CI 0·87-0·91] ）。自闭症 (0·79 [0·75-0·85]) 或智力障碍 (0·78 [0·73-0·83]) 的诊断与 HPV 疫苗接种率较低密切相关。与未按处方使用精神药物的女孩相比，接种疫苗的女孩也较低 (0·93 [0·92-0·95])，其中观察到抗精神病药物的关联性最强 (0·68 [0·56-0·82) ]）。第二剂的摄入率为 95·0%（92 912 中的 88 308），摄入量与女孩或其父母的心理健康状况之间没有很强的关联。我们的研究结果表明，有心理健康问题的女孩在预防宫颈癌方面存在差异，并且呼吁进一步研究以确保公平保护。瑞典癌症协会。版权所有 © 2024 作者。由 Elsevier Ltd 出版。这是一篇采用 CC BY 4.0 许可的开放获取文章。由爱思唯尔有限公司出版。保留所有权利。

Despite documented mental illness-related disparities in cervical cancer screening and incidence, insufficient data exist on differences in cervical cancer prevention strategies, such as human papillomavirus (HPV) vaccination. We aimed to investigate the association of mental illness and neurodevelopmental conditions among girls and their parents with uptake of HPV vaccination in Sweden.This population-based cohort study was based on the Swedish school-based HPV vaccination programme, which offers the first vaccine dose to girls aged 10-13 years, with a second dose offered within 12 months. We identified all girls born between Jan 1, 2002, and March 1, 2004, using the Swedish Total Population Register-ie, those eligible for two vaccine doses in the vaccination programme from its initiation in autumn 2012, to March, 2019. Nationwide Swedish register data (National Patient Register, Prescribed Drug Register, HPV Vaccination Register, National Vaccination Register, Total Population Register, Multi-Generation Register, Longitudinal Integrated Database for Health Insurance and Labour Market Studies, Education Register, National Cervical Screening Registry, and Cancer Register) were used to define individual and parental mental health conditions, including mental illness and neurodevelopmental conditions (defined by a clinical diagnosis and prescribed psychotropic medication use), HPV vaccine uptake (first and second dose), and sociodemographic and clinical characteristics. The two outcomes were uptake of the first HPV vaccine dose by the girl's 14th birthday and uptake of the second dose by the 15th birthday in relation to individual and parental mental health conditions, calculated using multivariable Poisson regression models.115 104 girls were included in the study population. 2211 girls (1·9%) had a specialist diagnosis of any mental health condition. Uptake of the first HPV vaccine dose was 80·7% (92 912 of 115 104) and was lower among girls with versus without any mental health condition (adjusted relative risk 0·89 [95% CI 0·87-0·91]). The diagnosis of autism (0·79 [0·75-0·85]) or intellectual disability (0·78 [0·73-0·83]) were most strongly associated with lower HPV vaccine uptake. Vaccine uptake was also lower among girls with versus those without prescribed use of psychotropic medication (0·93 [0·92-0·95]), with the strongest association observed for antipsychotics (0·68 [0·56-0·82]). Uptake of the second dose was 95·0% (88 308 of 92 912), with no strong associations between uptake and mental health conditions in girls or their parents.Our findings suggest disparities in cervical cancer prevention among girls with mental health conditions, and call for further research to ensure equitable protection.Swedish Cancer Society.Copyright © 2024 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.